Take Care

5 Tips for Caregivers: Better Medical Relationships

One of the lessons I learned early on in my time as a caregiver for my father was that he and I weren’t alone. I’m not talking about the support – both logistical and emotional – we received from family, neighbors and the amazing senior center in our little Cape Cod town. I’m talking about the doctors and nurses who, one by one, became a regular part of our lives. Their help was irreplaceable, but each relationship required its own care and nurturing.

If you’re taking on this job, you likely will be spending a lot of time in medical offices. The following five tips might help make the experience easier for you and your loved one, and may even lead to better quality care – I’m pretty sure they did both for my father.

Be nice. My first visit with Dad to a new specialist’s office – or to the hospital after the nursing shift had changed – was all about the smiling. Especially with the physician’s receptionist and nurses. You’ll generally spend 10 minutes, max, with the doctor, but the nurses and receptionists can be your access to faster callbacks and easier appointment rescheduling. If they connect your voice in an answering-service message with the smile they saw last week in the reception room, finding an answer to your question just might move to the top of their to-do list.

Be real. OK, so this might be starting to sound like a parent’s lesson on dating for a preteen child, but the advice still holds true. Initiate a conversation with the primary care physician (PCP) or specialist if there’s a particular issue causing problems. Is your aging father waking more frequently to use the bathroom at night, raising your own fears that he might fall? Let the PCP know – a simple change in when a diuretic is taken, or the addition of a generic prostate medication, could be all that’s needed help both you and your father enjoy a sounder sleep.

Be an advocate. For many older folks, doctors are authority figures to be listened to, and not questioned. It also can be very difficult for patients at any age to both absorb new information and be present enough to ask critical follow-up questions. This is why it’s important to be sitting next to your loved one at every medical appointment you’re able to attend. Asking a doctor that simple, one-word question – “Why?” – often can be the best service you’ll ever provide to someone you’re caring for.

Be firm. Doctors’ offices and hospitals can sometimes operate more like manufacturing lines than care facilities, and physicians and nurses can find it easier to work on assumptions rather than digging deeper. This can lead to mistakes. Don’t be afraid to dig in your heels when you feel a symptom is being overlooked. During one of Dad’s hospitalizations, the on-duty nurse attributed his growing incoherence to going cold turkey from his once-a-day Scotch. It was only my insistence that a doctor check him out that made the real problem evident: extremely low blood sugar.

When there’s a choice, choose personal interaction. This was especially true for me in dealing with Dad’s prescriptions. He was on a Medicare Preferred plan, and his insurer offered repeated incentives for him to go on a mail-order refill plan, which I just as repeatedly refused. Having a relationship with the local pharmacy (a branch of a major drugstore chain) saved us multiple times – they alerted us to drug-interaction problems Dad’s primary-care physician wasn’t aware of, and provided partial prescriptions to tide us over when prescription-renewal requests got held up. I doubt we ever would have gotten the same level of service from a mail-order provider. (Here’s a video covering questions you should be asking.)